Don’t blame GPs for overwhelming A&E units

Blaming GPs for overwhelming A&E units is a desperate attempt to find a
scapegoat

6:59AM BST 26 Apr 2013

SIR – The truth of how the crisis in out-of-hours health care arose (report, April 25) has been comprehensively distorted by Jeremy Hunt, the Health Secretary.

The changes to the out-of-hours contract in 2004 were a surprise to many GPs. After that, most out-of-hours care continued to be provided by groups of GPs working in associations of one sort or another.

Initially, the only real change was that the responsibility for overseeing these organisations moved from the GPs to local primary care trusts (PCTs).

Things went downhill when the Government encouraged PCTs, against the advice of most GPs, to split up elements of the service by devolving telephone call-handling to services with no immediate involvement in the delivery of care to patients, such as NHS Direct. These organisations are complicated to contact, have ludicrous telephone protocols and are risk-averse, leading to many unnecessary referrals to A&E.

Patients with experience of trying to get help via such services soon learn their lesson and vote with their feet, by either going directly to A&E or calling an ambulance.

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The GPs are still available to see patients but the interface that sits between the patient and the GP is defective.

Blaming them should be seen for what it is, a desperate attempt to find a scapegoat to hide the last two governments’ ineffectual meddling.

Dr Martin Shutkever Pontefract, West Yorkshire

Abu Qatada’s awayday

SIR – Why do we need to leave the European Human Rights Convention for six months to deport Abu Qatada (report, April 25)? Surely 24 hours would cover it.

Barry Smith Loughborough, Leicestershire

SIR – If one man, Abu Qatada, and his lawyers can outwit the Government almost daily, it bodes ill for any negotiations to repatriate powers from Brussels.

John Porter Poole, Dorset

Shine on, Mrs Hodge

SIR – As members of the Public Accounts Committee, we were surprised at your criticism of it and its chairman, Margaret Hodge (Leading article, April 24).

The committee is apolitical. It works on facts produced by the National Audit Office or elicited from witnesses during public hearings. The chairman is not politically biased, as can be seen from the committee’s attacks on performance by the previous Labour government, including the Department for Work and Pensions, where Mrs Hodge was a minister.

It is not true to say that the Public Accounts Committee has taken no evidence from academies themselves.

We can understand why some current ministers are unhappy at having a light shone upon whether their policies are being implemented effectively. However, that has been the job of the Public Accounts Committee for 150 years, and will continue to be so.

As to your charge that Public Accounts Committee criticisms “dovetail” with the official Labour position on many issues, we are impressed that you have discerned the Labour Party's policy on anything. No one else has.

SIR – Professor David Whittaker (Letters, April 24) is right about courts regarding teeth as a weapon when used in assault.

While Branislav Ivanovic has said he does not want to initiate a prosecution against Luis Suarez, there is clear evidence, by way of television footage and indeed Suarez’s own admission, that an offence under Section 4 (1) of the Public Order Act 1986 (using unlawful violence) has been committed.

Lee Bowyer was charged for this offence after he started a fight with his own team mate while playing for Newcastle United.

The Suarez incident was seen by countless children and other impressionable individuals. It is in the public interest for Merseyside Police to take action with a view to deterring highly paid role models from engaging in such reprehensible behaviour.

SIR – I have found the solution to soggy toast – a credit card-sized expanding toast rack which can be slipped into one’s wallet and which, when taken out, springs into toast-rack mode automatically.

Mark Roberts Hostert, Luxembourg

SIR – Richard Hoggart said in The Uses of Literacy (1964) that the working classes butter their toast hot. This is clearly superior to the cold, hard, dry and inedible contents of upper-class toast racks.

Rev Roger Holmes York

Lopsided Proms

SIR – One would expect the BBC Promenade Concerts to acknowledge the Wagner/Verdi bicentenary, and so they have, but in a curiously lopsided manner.

Wagner is accorded the accolade of seven full-length operas, including the whole of The Ring, unprecedented in Proms history. Verdi is represented by a succession of what Sir Thomas Beecham would have called “lollipops”, plus the Four Sacred Pieces and the rarely played string quartet. The implication is clear: Wagner wrote operas for grown-ups and Verdi was that engaging chap who gave the plebs tunes they could whistle.

I find this extraordinarily patronising. For those who prefer the flesh and blood of Verdian drama to Wagner’s Teutonic myths, Don Carlo is as great an opera as Die Walküre or Siegfried, and Nabucco as fine as Tannhäuser.

Richard Last Woking, Surrey

Ducks’ danger zone

SIR – At this time of the year we get ducks in our small garden pond (Letters, April 23). Every year I chase them away. I regard this as a kindness, having seen the local suburban fox take the ducklings for breakfast.

Herbert Potts Bramhall, Cheshire

SIR – Foxes do not kill “for the sake of it”. Given an opportunity such as a henhouse, they will kill as many birds as possible and, over time, carry them off and bury them for later consumption.

Because humans tend to remove the birds before stage two, foxes are unfairly labelled as psychopaths. You might as well say that humans buying meat for the freezer are killing for the sake of it.

Cynthia Harrod-Eagles Northwood, Middlesex

Red ink is too harsh a colour for marking

SIR – Anna Maxted’s article bemoaning the lack of correction in pupils’ exercise books (Features, April 24) took me back to my own teaching days in the Eighties.

I had heard of a teacher in France who marked pupils’ work in green, rather than red, and I decided to ask my classes how they would like their work corrected.

There was no contest: 100 per cent chose green. They felt that red was a harsh colour, whereas green was a complementary colour to their work in blue.

It was adieu to the red pen.

Noel Slaney Tewkesbury, Gloucestershire

SIR – Anna Maxted was mystified by the black dots placed on her son’s schoolwork.

When on my first PGCE teaching placement in 1993, I too was told to mark with a dot rather than a cross, as, unlike a cross, a dot could later be turned into a tick, thus leaving no negative record.

The phrase “trial and error” was replaced with “trial and improvement” for mathematical investigations, lest there be an aura of negativity.

There was a ban on red ink, correcting spellings, and telling children that anything they suggested was incorrect.

I left teaching, dispirited, in 1999.

Frances Williams Swindon, Wiltshire

SIR – My school did put red ink to good use. I do not think it harmed any of us, but it certainly made us more careful.

Once I wrote of a “typical type” of something – words that came back ringed in red, with “tautology” scrawled in the margin.

That was 70 years ago, but I can still picture today that vivid red ring.